IGF-1 Inhibitor Pasireotide Lar in Combination With the m-TOR Inhibitor Everolimus

Inclusion Criteria:

* Histologically documented multiple myeloma
* Multiple myeloma relapsing or refractory to at least 2 of the currently accepted therapies for multiple myeloma
* Age \> 18 years
* Minimum of 4 weeks since any major surgery, radiation or 5 half life since prior systemic anticancer therapy
* ECOG performance status ≤ 2
* Anticipated life expectancy of 12 weeks or more
* Adequate bone marrow function
* Adequate liver function
* Calculated creatinine
* INR ≤ 1.5
* Fasting serum cholesterol ≤ 300 mg/dL or ≤ 7.75 mmol/L and fasting triglycerides ≤ 2.5 x ULN
* Women of childbearing potential must have a negative serum pregnancy test. Women must not be lactating. Both men and women of childbearing potential must be advised of the importance of using effective birth control during the course of the study.

Exclusion Criteria:

* Patients should not receive immunization with attenuated live vaccines within one week of study entry or during study period.
* Patients should not receive immunization with attenuated live vaccines during study period or within 1 week of study entry.
* Patients with prior or concurrent malignancy
* Patients with uncontrolled diabetes mellitus
* Patients who have congestive heart failure, unstable angina, sustained ventricular tachycardia, ventricular fibrillation, clinically significant bradycardia, advanced heart block or history of acute myocardial infarction within the 6 months preceding enrollment.
* Liver disease
* Patients who have any severe and/or uncontrolled medical condition or other conditions that could affect their participation in the study.
* Female patients who are pregnant or breast feeding, adults of reproductive potential who are not using effective birth control methods.
* Male patients whose sexual partner(s) are women of child bering potential and who are not willing to use adequate contraception during the study and for 8 weeks after the end of treatment.
* Patients with a known hypersensitivity to everolimus or other rapamycin or to its excipients.
* Known hypersensitivity to somatostatin analogues or any component of the pasireotide or octreotide LAR formulations
* History of noncompliance to medical regimens
* Patients unwilling to or unable to comply with the protocol
* Patients taking medication know to inhibit, induce or be a substrate to isoenzyme CYP3A
* QTcF at screening \> 450 msec, history of syncope or family history of idiopathic sudden death, sustained or clinically significant cardiac arrhythmias, risk factors for Torsades de points, concomitant disease that could prolong QT intervals, use of concomitant medications know to prolong the QT interval.